The current scientific evidence on the effectiveness of e-cigarettes for smoking cessation is limited, but shows e-cigarettes may be at least as effective as nicotine replacement therapy (NRT), which is a standard treatment for cessation and broadly recommended by health professionals (HPs). E-cigarettes are now more popular for cessation than licensed NRT and prescription medications in countries such as England, the United States (US), and Canada; however, debate exists on whether HPs should advise smokers to use e-cigarettes, particularly for those who have medical comorbidities (e.g., chronic lung disease). The present study included smokers from four countries to examine: (1) the prevalence of: (i) HP advice to quit smoking, (ii) discussions about e-cigarettes, and (iii) recommendations to use e-cigarettes; and (2) smoker’s characteristics associated with discussing e-cigarettes and receiving advice to use them.

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Method

Data come from the 2016 International Tobacco Control (ITC) Policy Evaluation Project Four-Country Tobacco and E-cigarette Survey, which includes nationally representative samples of adult (≥18 years) smokers from Canada (n=1,922), the US (n=1,501), England (n=2,105), and Australia (n=1,038). Participants eligible for analysis had visited a HP in the last year.

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Result

Among all smokers who visited a HP in the last year, 47.5% received advice to quit smoking, 6.8% reported discussing e-cigarettes, and 2.1% of smokers were recommended to use an e-cigarette (36.1% of those who had a discussion). Discussions and e-cigarette recommendation were more common among smokers who were: younger, highly educated, advised to quit smoking, more frequent e-cigarette users, positive about e-cigarettes, and believed that the public approved of vaping. While smokers with diabetes (p=0.026) or cancer (p=0.018) were more likely to discuss e-cigarettes with a HP, they were not more likely to be recommended to use them. Smokers with chronic lung disease were more likely to be recommended to use an e-cigarette than smokers without lung disease (p=0.026).

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Conclusion

These findings suggest that HPs are not taking advantage of discussions with smoking patients to encourage cessation, to provide information about different smoking cessation methods (e.g., suggest e-cigarettes as a cessation aid for smokers who are not willing or able to quit with other strategies), and to encourage smokers who are not inclined to quit to use e-cigarettes as a less-harmful alternative to smoking. More research is urgently needed to assess whether e-cigarettes are a viable alternative to cigarettes for people with lung disease to help them stop smoking and prevent further lung deterioration.

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Information from this presentation has been removed upon request of the author.

Information from this presentation has been removed upon request of the author.